Promoting Green Buildings and Low-Carbon Design Strategies of Green B&B Rooms for Sustainable Tourism after COVID-19

COVID-19 opened a window of opportunity to change the green development of the hospitality industry. For many years, Chinese tourists have been the world's largest source of outbound tourists. Therefore, this study attempted to improve built-environment strategies for green rooms at B&Bs using the empirical statistics of Chinese tourists after the end of COVID-19 control measures and different green B&B standards, combining IPA (importance-performance analysis). For the lack of a green built-environment study from a tourism perspective, this study can be used mainly for improving the green satisfaction of urban B&Bs as it attempted to fill the gaps in research on green B&B rooms. This study will significantly help improve the quality of green rooms for the B&B industry in the future, and it also provides an improved green B&B room sample for other countries and regions. Moreover, it is an optimistic attempt at hospitality and tourism recovery. © 2023 by the authors.

Antibody Responses to an Additional Dose of SARS-CoV-2 mRNA Vaccine in Solid Organ Transplant Recipients with and without HIV

Purpose: Solid organ transplant (SOT) recipients mount suboptimal immune responses to a two-dose SARS-CoV-2 mRNA vaccine series. Data regarding antibody responses in HIV and SOT remains limited. We characterized spike binding antibody responses before and after an additional mRNA vaccine dose in SOT recipients, including in people with HIV (PWH). Method(s): Spike binding antibody titers were assessed before and one month after an additional vaccine dose using a quantitative ELISA. An additional vaccine dose was defined as a third dose of a mRNA vaccine primary series, as recommended by the CDC. Result(s): Antibody titers were assessed in 64 SOT recipients (58% kidney, 34% liver, 8% other). Participants had a median age of 57 and 47% were women. PWH comprised 14% of the cohort (9/64, 78% kidney). 70% (45/64) of SOT recipients developed antibodies after a two-dose vaccine series (62% kidney, 33% liver). The additional dose was given a median of 169 days (IQR 144.75-185.75 days) after the second vaccine dose, and 72% received three doses of BNT162b2 (Pfizer-BioNTech) while 28% received three doses of mRNA-1273 vaccine (Moderna). The median time between transplantation and an additional vaccine dose was 2.8 years (IQR, 0.6-8.9). 32% (6/19) of SOT recipients who had no detectable antibody seroconverted after receiving an additional vaccine dose. The 45 participants who were seropositive prior to the third dose displayed a median 4.4-fold increase in antibody titers. SOT recipients with HIV had comparable antibody responses to those without HIV. Conclusion(s): Our data indicate that SOT recipients benefit from an additional SARS-CoV-2 mRNA vaccine dose. SOT recipients with and without HIV appear to mount comparable antibody responses upon vaccination, although larger numbers are needed.

Multi-perspective Characterization of Anaphylactic Risk for COVID-19 Vaccination - A Visual Analytic Approach

Currently, communications of the COVID-19 vaccine risk and benefit have been confusing and ineffective. This research presents a visual analytical approach to enable decision-driven, multi-perspective risk characterization of COVID-19 vaccination. Using data collected from Vaccine Adverse Event Reporting System (VAERS), we designed multiple-views dash-boards based on identified risk factors to support interactive explorations of anaphylactic risks from policy, clinical, and personal contexts. Based on the hypothetical scenarios, we showed that our visual analytical approach offers multiple benefits for risk characterization tasks, including flexibility in focusing on the subset of risk factors that are specific to user's decision context, exploring and assessing risk in multiple levels of details, and characterizing risk metrics together with uncertainties. Our method and tools have potentials of improving COVID-19 vaccine risk communication to address vaccine hesitancy and to inform public policy. © 2022 IEEE.

EXPLORING KNEE OSTEOARTHRITIS PAIN TRAJECTORIES and MOVEMENT-EVOKED PAIN CHANGES during A 24-WEEK OUTDOOR WALKING PROGRAM (WALK)

Background: Exercise therapy is recommended as frst line treatment for knee osteoarthritis (OA), but it remains to be sub-optimally applied (1). Movement-evoked pain is a potential barrier to exercise adherence, but recent evidence suggests that such pain can be improved by training (2). Walking programs are low-cost, easily adopted and can be performed outdoors which can minimize the risk of SARS-CoV-2 transmission when in a group (3). Objectives: To explore the acute pain trajectories of individuals with knee OA during a 24-week outdoor walking intervention. In addition, to explore the effect of pain trajectories and/or baseline characteristics on retention and adherence. Methods: Individuals with clinical knee OA and bone marrow lesions (BMLs) on magnetic resonance imaging (MRI) were asked to follow a 24-week walking program. Every week consisted of two one hour supervised group sessions at various outdoor locations and one unsupervised session. At the start and end of every supervised group walk, knee pain was self-reported by participants to their trainer using a numerical rating scale (NRS) (0-10). The difference between the NRS pain values was considered as an acute pain change evoked by that walk. At baseline, the most affected knee of each participant was assessed using the Visual Analogue Scale (VAS) pain, the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) pain, stiffness and function, wellbeing (3 questionnaires) and the Osteoarthritis Research Society International (OARSI) recommended strength and performance measures. Results: In total, N = 24 participants started the program of whom N = 7 (29%) withdrew. Pain at the start of each walk decreased from NRS 2.5 (SD 1.6) at the frst walk (N = 24) to NRS 0.9 (SD 0.8) at the fnal walk (N = 17). This pain was estimated to decrease on NRS by-0.04 (95% CI-0.05 to-0.02) per supervised session, p < 0.001 during the frst 12 weeks and-0.01 (95% CI-0.02 to-0.004), p = 0.004 during the second twelve weeks of the program. The number (%) of participants who experienced an acute increase in pain decreased from 11 (45.8%) at the frst walk to 4 (23.5%) at the last walk. At baseline, non-adherent participants (<70% of group sessions) (N = 11) had lower physical performance scores, including the 30s Chair Stand Test (mean 10 (SD 1.7) stands versus mean 12.0 (SD 1.7) stands, p = 0.011), Fast Past Walk Test (1.23 (SD 0.14) meter per seconds (m/s) vs 1.50 (SD 0.20) m/s, p = 0.001), Six Minute Walk Test (418.8 (SD 75.9) m vs 529 (SD 72.6) m, p = 0.002), compared to adherent participants (N = 13). Non-adherent participants also had less severe self-reported symptoms including WOMAC stiffness (90.7 (SD 44.5) mm vs 121.5 (SD 17.0) mm, p = 0.031), compared to adherent participants. During the frst two weeks of walking, acute increases in pain on average (mean ≥0.5 NRS) were reported by a greater number of non-adherent (N = 5 (45.5%)) than adherent participants (n = 4 (30.8%)). Conclusion: This was an exploratory study and results need to be interpreted with caution due to the small sample size. The walking program resulted in clinically important improvements (MCIIs) (≥ 1 on NRS) (4) in start pain and acute pain changes. Improvements in start pain during the frst 12-weeks were comparable to improvements measured in the NEMEX program (2) and may suggest that 12 weeks of exercise is sufficient to achieve MCIIs in pain. Improvements in acute changes in pain were smaller, which may have been related to a foor effect (5). Lower physical performance scores at baseline and more acute increases in pain during the frst two weeks was associated with non-adherence. Participants with these characteristics may beneft from a lighter introduction to exercise.

MXT: A New Variant of Pyramid Vision Transformer for Multi-label Chest X-ray Image Classification

Nowadays, the global COVID-19 situation is still serious, and the new mutant virus Delta has already spread all over the world. The chest X-ray is one of the most common radiological examinations for screening catheters and diagnosis of many lung diseases, which plays an important role in assisting clinical diagnosis during the outbreak. This study considers the problem of multi-label catheters and thorax disease classification on chest X-ray images based on computer vision. Therefore, we propose a new variant of pyramid vision Transformer for multi-label chest X-ray image classification, named MXT, which can capture both short and long-range visual information through self-attention. Especially, downsampling spatial reduction attention can reduce the resource consumption of using Transformer. Meanwhile, multi-layer overlap patch (MLOP) embedding is used to tokenize images and dynamic position feed forward with zero paddings can encode position instead of adding a positional mask. Furthermore, class token Transformer block and multi-label attention (MLA) are utilized to offer more effective processing of multi-label classification. We evaluate our MXT on Chest X-ray14 dataset which has 14 disease pathologies and Catheter dataset containing 11 types of catheter placement. Each image is labeled one or more categories. Compared with some state-of-the-art baselines, our MXT can yield the highest mean AUC score of 83.0% on the Chest X-ray14 dataset and 94.6% on the Catheter dataset. According to the ablation study, we can obtain the following results: (1) The proposed MLOP embedding has a better performance than overlap patch (OP) embedding layer and non-overlap patch (N-OP) embedding layer that the mean AUC score is improved 0.6% and 0.4%, respectively. (2) Our demonstrate dynamic position feed forward can replace the traditional position mask which can learn the position information, and the mean AUC increased by 0.6%. (3) The mean AUC score by the designed MLA is more 0.2% and 0.6% than using the class token and calculating the mean scores of all tokens. The comprehensive experiments on two datasets demonstrate the effectiveness of the proposed method for multi-label chest X-ray image classification. Hence, our MXT can assist radiologists in diagnoses of lung diseases and check the placement of catheters, which can reduce the work pressure of medical staff.

Influence of landscape outside the window on the anxiety level of self-separation people during COVID-19

Windows are the communication medium between indoor and outdoor, but their influence and the corresponding landscape outside the window are often ignored due to the outdoor frequent activities of people. The coronavirus disease 2019 (COVID-19) has been a better choice to show the window performance, especially for the anxiety level alleviation of people isolated at home. A national survey was conducted on the anxiety of self-separation people and the window influence. The results showed that the average anxiety level was 1.54, between a little anxious and anxious, due to the COVID-19. The best satisfaction with the landscape outside the window was waterscape (2.98), followed by green plants (2.33) and buildings (0.83). During the COVID-19, the average number of overlook times increased by 1.49 times/day, which is higher 0.42 ties/day than the normal condition. The landscape types had the certain influence on the overlook frequency, the window opening times and even the anxiety level. The average anxiety levels are 1.36 and 1.68 with natural landscapes and human landscapes, respectively. Optimizing the landscapes outside the window plays an important role in alleviating the anxiety of residents and improving their mental health.

Ambient noise level in eastern north china from chinarray and its response to covid-19

High-frequency ( > 1 Hz) ambient noise is usually closely related to anthropogenic activities. During the outbreak and spread of the COVID-19, as various anthropogenic activities are restricted, high-frequency ambient noise level has been observed to be reduced on a worldwide scale. The continuous waveform data at dense broadband seismic stations from ChinArray in eastern North China provides a good opportunity to study the temporal and spatial patterns of the ambient noise level in the region, and to further study the influencing factors, such as the topography and the population density. In this study, we calculated the average power spectral density of ambient noise at each station ±90 days around the Spring Festival in 2019 and in 2020, analyzed the noise level at different stations through normal times, Spring Festivals, epidemic control period, and recovery period, and studied the influencing factors of the noise level. We found that normally high-frequency (1-10 Hz) ambient noise correlates well with the surrounding sedimentary thickness: The noise level is higher when the surrounding sedimentary layer is thicker and vice versa. It correlates moderately with local population density and is time-varying due to anthropogenic activities. During the Spring Festival in 2019 and in 2020, and the epidemic control period after the Spring Festival in 2020, the reduction extent of the noise level correlates moderately with both the sedimentary thickness and population density;the ambient noise level reduces more significantly to the south of 40° N than to the north of it in the study region. Considering that the sedimentary thickness beneath each station is not time-varying, the variation in ambient noise level due to anthropogenic activities is clearly amplified by the sedimentary layer. © 2021 Seismological Society of America. All rights reserved.

An evaluation of green ryokans through a tourism accommodation survey and customer-satisfaction-related casbee–ipa after covid-19 pandemic

Following the outbreak of the COVID-19 pandemic, it became significant to study how to improve the customer satisfaction for Japanese tourist accommodations for restart and recovery in the future, and in preparation for the 2021 Japan Olympics. Therefore, the current paper attempts to evaluate ryokans through descriptive statistics from a tourism accommodation survey and customer-satisfaction-related comprehensive assessment system for built environment efficiency (CASBEE) importance–performance analysis (IPA). Through three progressive studies, three findings were obtained: (1) ryokans are more flexible than hotels, have strong anti-risk capabilities, and have received more and more attention from tourists and support from the Japanese government;(2) improvement strategies for customer satisfaction after COVID-19 were provided from IPA;and (3) a dynamic evaluation model of green ryokans was discussed and may be employed in other countries and regions experiencing the same situation. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.